Date of Award


Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)



First Advisor

Kaveh Khoshnood


U.S. students are participating in global health electives and research in low- and middle-income countries (LMIC) in increasing numbers, yet the significant ethical challenges they face have not been well documented. We conducted a mixed methods study of graduate, health professional and undergraduate students at a research-focused university about their experiences conducting global health research activities, focusing on ethical challenges and support for addressing those challenges. An online, structured questionnaire was completed by 123 participants, and in-depth, semi-structured interviews were conducted with 17 participants and analyzed using the constant comparison method. Among questionnaire respondents, 31% reported a significant or moderate impact of ethical challenges on their fieldwork, and 36.6% felt well prepared to deal with those challenges. Ethical challenges, described by both questionnaire and interview respondents, fell broadly into the categories of human subjects protections, impact of research, corruption, and scope of practice. Most students (76%) had received some form of pre-departure ethics training, but many felt those sessions were not well aligned with actual experiences. Additionally, respondents expressed a desire for more faculty, peer and host support before, during and after fieldwork. These results suggest a need for universities to develop and implement standards for preparation and oversight of student research activities in LMIC.

Open Access

This Article is Open Access